Biomarkers Identify Acute Kidney Injury in Emergency Patients

In an international study of 1,635 emergency-department patients, urinary neutrophil gelatinase-associated lipocalin (uNGAL) was the most useful of five urinary biomarkers in predicting the severity and duration of acute kidney injury (AKI) at the time of hospital admission, with 81% specificity and 68% sensitivity at a cutoff of 104 ng/mL.

In the study by Thomas L. Nickolas, MD, MS, and colleagues, which was published in the Journal of the American College of Cardiology (2012;59:246-255), uNGAL and another biomarker, urinary kidney injury molecule 1, predicted a composite outcome of dialysis initiation or death during hospitalization, improved the net risk classification compared with conventional assessments, and identified a substantial subpopulation of patients who had low serum creatinine at hospital admission but were at risk of adverse events.